POS0628 CLINICAL AND LABORATORY FEATURES OF RHEUMATOID ARTHRITIS IN COMBINATIONS WITH SJOGREN’S SYNDROME IN CLINICAL PRACTICE OF RHEUMATOLOGICAL HOSPITAL.
Authors: A. Torgashina, E. Matianova
Journal: Annals of the Rheumatic Diseases (2022)

Background Overlap syndrome of rheumatoid arthritis (RA) and Sjogren`s syndrome (SjS) characteristically manifested with more visceral involvements and has his own features of the articular syndrome. This issue is not well covered in the literature. Objectives To determine the clinical and laboratory features of RA in combination SjS, in cases where biologic therapy was prescribed. Methods 505 patients (pts) were enrolled in observational cross-sectional study. These patients were examined and treated in our clinic in 2021 year. RA was diagnosed according to the 2010 ACR/EULAR criteria. SjS was diagnosed on ECR/EULAR 2016 criteria in 155 (30.7%) pts. Thus, 2 groups (grs) were identified for comparative analysis: pts with RA in combination with SjS (n=155) (group S) and pure RA (n=350) as a control group (gr C). Results In gr S there were two times less men (8.4% and 17.7%, p=0.004) and pts were older (53.6±12.5 and 48.8±15, p&lt;0.001), while the duration of disease didn`t differ significantly and amounted 10 (5-16) years. Tender joints score and the duration of morning stiffness in the joints were comparable. Other indicators of RA activity (swollen joints score, VAS of pts, ESR, CRP), as well as calculated activity indices (DAS28ESR, DAS29CRP) in gr S were significantly lower than in gr C (Table 1). The frequency of erosive arthritis was similar for this grs. Leukopenia was more common in the gr S (p=0.004). Pts of gr S had positive values of RF and ACCP more often (p≤0,005). Table 1. Indicators of RA activity at study entry. S (n=155) C (n=350) р tender joints score, М±SD; Me [25; 75] 9,1±5,3; 8[4;12] 9,5±5,8; 8[5;13] p&gt;0.05 swollen joints score, М±SD; Me [25; 75] 5±4,5; 4[2;7] 6±4,1; 5[3;9] 0,02 VAS pts, М±SD; Me [25; 75], mm 58,9±16,1; 60[50;70] 63,9±13,2; 65 [60;70] 0,0003 ESR, М±SD; Me [25; 75], mm/h 27,9±28,4; 18[9;34] 36,3±35; 22[11;51] 0,009 CRP, М±SD; Me [25; 75], g/l 14±20,2; 5[1,4;17,8] 23,8±29,5; 11,7[3,5;33,8] 0,0002 DAS28СОЭ, М±SD; Me [25; 75] 5±1,3; 4,9[3,9;6,2] 5,4±1,2; 5,4[4,5;6,3] 0,005 DAS28СРБ, М±SD; Me [25; 75] 4,7±1,2; 4,6[3,7;5,6] 5±1,1; 5,1[4,3;5,8] 0,0007 Morning stiffness М±SD; Me [25; 75], min 109,8±98; 60[30;140] 122,7±96,4; 90[42,5;180] p&gt;0.05 The frequency of prescribing methotrexate or leflunomide at the onset of the disease was comparable. Hydroxychloroquine was more often prescribed in the gr S at the onset of the disease (16% and 6%, p&lt;0.001) and at the time of analysis (22.6%, 8.6%, p&lt;0.001). The frequency and duration of oral glucocorticoids (GCs) in the grs were comparable, but at the time of hospitalization GCs were received at lower doses in gr S (p=0.02). The first biological drugs, prescribed at the onset of the disease were more often TNFα blockers in gr C and rituximab in gr S. Conclusion According to our observations, the combination of RA with SjS leads to a milder course of the RA. Early diagnosis of SjS in RA pts is important for understanding the course of the disease and determining the prognosis. Disclosure of Interests None declared